Continuous peripheral nerve blocks in acute pain management

被引:41
作者
Chelly, J. E. [1 ]
Ghisi, D.
Fanelli, A.
机构
[1] Univ Pittsburgh, Med Ctr, Div Reg Anesthesia, Dept Anesthesiol, Pittsburgh, PA 15260 USA
关键词
acute pain; continuous nerve blocks; local anaesthetics; regional anaesthesia; TOTAL-HIP-ARTHROPLASTY; CONTINUOUS LUMBAR PLEXUS; PSOAS COMPARTMENT BLOCK; TOTAL KNEE ARTHROPLASTY; CONTINUOUS INTRAARTICULAR INFUSION; PATIENT-CONTROLLED ANALGESIA; POSTOPERATIVE PAIN; FEMORAL NERVE; REGIONAL-ANESTHESIA; RETROPERITONEAL HEMATOMA;
D O I
10.1093/bja/aeq322
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
The indications for continuous nerve blocks for the perioperative pain management in hospitalized and ambulatory patients have extended well beyond orthopaedics. These techniques are not only used to control pain in patients undergoing major upper and lower extremity surgery, but also to provide perioperative analgesia in patients undergoing abdominal, plastic, urological, gynaecological, thoracic, and trauma surgeries. Infusion regimens of local anaesthetics and supplements must take into consideration the condition of the patient before and after surgery, the nature and intensity of the surgical stress associated with the surgery, and the possible need for immediate functional recovery. Continuous nerve blocks have proved safe and effective in reducing opioid consumption and related side-effects, accelerating recovery, and in many patients reducing the length of hospital stay. Continuous nerve blocks provide a safer alternative to epidural analgesia in patients receiving thromboprophylaxis, especially with low molecular-weight heparin.
引用
收藏
页码:I86 / I96
页数:11
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